Where to Buy NAD+ Online: Injection, Nasal Spray, IV and Oral Compared

NAD+ Injection is a multi-dose vial of NAD+ in sterile solution, drawn into an insulin syringe and injected into the fat layer of the abdomen or thigh. The reviewed directions on the product page are three injections per week, and one vial covers about four weeks at that rhythm. It is the form Pepti prescribes in all 50 states and DC. The same medication comes as a pre-filled cartridge for the Pepti Pen, dosed in clicks rather than drawn with a syringe; Pen availability by state is shown at checkout.

NAD+ Injection (500 mg) is the same molecule at half the concentration in the same vial size. It exists because the characteristic reaction to NAD+ tracks with how much enters the circulation how quickly, and a lower concentration at the same volume is one way a physician can start someone gently. Which vial you receive is your physician's decision. It has its own reference page.

NAD+ Nasal Spray is a metered bottle instilled into each nostril, twice daily on the reviewed directions. It is chosen by people who will not inject, and by physicians who want a lower, more frequent exposure. The caveat is that nasal absorption of NAD+ in humans has not been characterised: the intranasal work is in rats, including a 2007 study in Frontiers in Bioscience and a 2012 study in the Journal of Neurotrauma, and the general pharmacology of nasal delivery, reviewed in the Journal of Controlled Release in 2003, says large charged molecules cross the nasal lining poorly. It is available in fewer states than the injection, because the pharmacy that compounds it is licensed in a subset of them; the current count is on the product page. Details in what NAD+ nasal spray is.

An intravenous infusion delivers NAD+ into a vein over hours, in person, under supervision, so the "online" part is a booking form. The one published human study of NAD+ given directly, a 2019 pilot in Frontiers in Aging Neuroscience, used this route: a six-hour infusion in healthy participants, measuring what happened to the molecule in blood and urine. It is also the route most associated with the flushing and chest-tightness reaction, which is why it is infused so slowly.

NR and NMN capsules are sold as dietary supplements. They are the form with the randomised human trials, described below. What they are not is NAD+: the capsule contains a precursor, and the body has to convert it. A 2016 study in Nature Communications reported that NR is orally bioavailable and raises NAD+ metabolites in blood in mice and humans, and a 2017 open-label study in PLOS ONE reported the same in healthy volunteers. So the capsule does something measurable in blood; whether that reaches the tissues people care about is the open question. Comparing the four routes by milligrams is the most common mistake in NAD+ marketing: the infusion goes straight into plasma, the injection enters through fat at whatever pace it is pushed, the spray has to cross the nasal lining, and the capsule is a different molecule.

Most people arrive at NAD+ because of fatigue, low drive or a feeling of running slow, and the list of things that produce that picture is long: poor sleep, an underactive thyroid, low iron or B12, depression, sleep apnea, a medication side effect. A physician who prescribes NAD+ without asking about those is not doing the job. The free assessment is where it starts.

Bloodwork is not routinely required for NAD+ Injection, but your physician may want it depending on your history, and at-home blood testing is available if they do. The physician can decline, and a consultation does not guarantee a prescription; being declined is refunded. A service that never declines is not reviewing anything.

An NAD+ prescription specifies the product (the standard vial, NAD+ Injection (500 mg), the Pen cartridge or NAD+ Nasal Spray), the volume per dose, the frequency, and the pace at which to give it. The dosing is only ever what is on the product page, and it is the physician's decision. If you want the lower strength to start, say so at intake.

The pharmacy prepares your NAD+ Injection to that prescription and ships it refrigerated with your name, the strength and your directions on the label. Pepti's NAD+ products are compounded at a US FDA-registered pharmacy. Registration is a real, checkable status for a drug establishment; it is not approval. Compounded drugs are not FDA approved, and the FDA does not verify their safety, effectiveness or quality before they are marketed.

The vial arrives cold, goes in the refrigerator, and the first dose is usually a smaller one given slowly. Refills run on a 28-day cycle, one vial per fill, until you cancel in your account. The prescriber stays reachable, and the first message most people send is about pace. There is no in-person visit and no mandatory lab panel unless your physician wants one, and no provider should require a "loading protocol," a bundle of vials up front, or an IV session before you are "allowed" the injection. Each of those is a sales structure, not a clinical one.

A telehealth provider should be able to tell you that the physician reviewing your intake is licensed in your state, and you can verify any physician through your state medical board's public license lookup with a name. A provider that describes a "medical team" with no named licensee, or will not say who reviews your file, has answered the question.

Ask which pharmacy will compound your NAD+ Injection and in which state it holds its license; every state board of pharmacy publishes a lookup. A pharmacy shipping into your state must be licensed or registered as a non-resident pharmacy there, which is also why the nasal spray is available in fewer states than the injection, and a legitimate provider will tell you that rather than ship anyway.

A certificate of analysis is a laboratory's report on a specific lot: identity, concentration, and for an injectable, sterility and bacterial endotoxin. For NAD+ specifically, the endotoxin result is the line that matters most, for the reason the FDA's 2024 reminder spelled out. A purity percentage alone, which is what research sellers advertise, says nothing about whether a vial is safe to inject. Pepti publishes certificates for NAD+ at lab results, the standards behind them on the quality page, and how to read one in how to read a certificate of analysis.

A prescription label carries your name, the drug, the strength, the volume, the directions including pace, the pharmacy's name and phone number, the prescriber's name, the date and a beyond-use date. A research vial carries a product name, a milligram figure and a disclaimer. If the vial that arrives has no name on it and no pharmacy identified, you did not receive a prescription, whatever the checkout page said. Afterwards there should be a way to message the physician about a reaction or a dose question; that pathway is what a research seller's "not for human use" clause removes.

The FDA keeps a list of bulk drug substances nominated for use in compounding under section 503A, sorted into three categories. In the version updated 14 May 2026, nicotinamide adenine dinucleotide (NAD) sits in Category 1, "Bulk Drug Substances Under Evaluation," and so does its reduced form, nicotinamide adenine dinucleotide disodium reduced (NADH). A separate salt form, beta-nicotinamide adenine dinucleotide disodium salt trihydrate, is in Category 3, meaning that particular nomination was filed without enough supporting information for the FDA to evaluate it. Neither NAD nor NADH is in Category 2, which as of the May 2026 update contains six substances, none of them NAD-related.

Category 1 substances "may be eligible for inclusion on the 503A bulks list, were nominated with sufficient supporting information for FDA to evaluate them, and do not appear on any other list," and the FDA "does not intend to take action against a compounder for compounding drugs using bulk drug substances listed in category 1, provided that the conditions described in the guidance document are met." That interim policy is the basis on which a state-licensed 503A pharmacy compounds NAD+ Injection and NAD+ Nasal Spray to a prescription today. It is not approval, and it is not the FDA saying the substance is safe or effective; it is the FDA saying the evaluation is open and the substance has not been flagged.

The FDA's own review of the NAD nomination did not go the substance's way. A proposed rule published in the Federal Register on 5 September 2019 listed both NAD and NADH among the substances the agency had considered and proposed not to include on the 503A bulks list. That rule has not been finalised for NAD as of September 2026, which is why the substance remains in Category 1 and compoundable under the interim policy. A seller telling you the FDA "supports" NAD+ is describing a pending evaluation whose only formal proposal so far went the other way.

In April 2026 the FDA moved twelve peptides out of Category 2 after their nominations were withdrawn, and on 23–24 July 2026 the Pharmacy Compounding Advisory Committee reviewed several of them. NAD+ was not among the twelve, because it was never in Category 2, and it was not on the July agenda. Pages written about "the FDA peptide ban" or "peptides back on the market" in 2026 are about other compounds. NAD+ is not a peptide and its regulatory status did not change this year.

No NAD+ product, injectable, nasal, intravenous or oral, is an FDA-approved drug. The compounded forms are prepared by licensed pharmacies pursuant to a prescription rather than approved as manufactured products, and the FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed. The oral precursors are sold under dietary supplement rules, which is a different regime and not an approval either.

There are no randomised controlled trials of subcutaneous NAD+ Injection in humans, and none of NAD+ Nasal Spray. The only published study of NAD+ given directly to people is the 2019 pilot in Frontiers in Aging Neuroscience: a six-hour intravenous infusion in healthy participants. It reported that plasma NAD+ did not rise for the first two hours of the infusion, with a metabolite pattern consistent with the molecule being broken down as fast as it arrived. The likeliest reading is that infused NAD+ is degraded outside cells into fragments that tissues rebuild through the same salvage pathway a precursor feeds. That is a hypothesis from one small study, and nothing equivalent has been published for the subcutaneous or nasal routes.

The randomised human trials are of NR and NMN capsules, reported here because they are the best evidence on what raising NAD+ in people does, not because they are trials of the injection. A 2018 trial in Nature Communications by Martens and colleagues reported NR well tolerated in healthy middle-aged and older adults and raising NAD+ in blood cells. A 2018 trial in the American Journal of Clinical Nutrition by Dollerup and colleagues gave obese, insulin-resistant men NR or placebo for twelve weeks and reported no improvement in insulin sensitivity, glucose metabolism or body composition. A 2021 trial in Science by Yoshino and colleagues gave postmenopausal women with prediabetes NMN for ten weeks and reported increased skeletal-muscle insulin sensitivity. A 2023 GeroScience trial in eighty healthy middle-aged adults and a 2019 trial in Scientific Reports in healthy overweight adults both reported dose-dependent rises in blood NAD+ with no safety signal. The NADPARK phase I trial in Cell Metabolism in 2022 reported higher brain NAD on spectroscopy after thirty days of NR in newly diagnosed Parkinson's patients, and the 2024 NICE trial in Nature Communications reported a modest improvement in six-minute walk distance after six months of NR in peripheral artery disease, with a confirmatory trial called for. The pattern: precursors reliably raise blood NAD+; functional effects are small, inconsistent, and strongest in older or metabolically impaired participants.

• That NAD+ Injection raises tissue NAD+ in humans; nobody has measured it.
• An effect on energy, cognition, aging or longevity in people, for any route.
• That the nasal spray delivers a meaningful dose; the intranasal work is in rats.
• A timeline. What prescribers describe is patient report over a few weeks, not a trial endpoint.
• An approved use for anything.